| NPI | 1992145940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN29906) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL D-0006608-C1) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2026-01-14 |